Leaderboard

Who In Here Believes That All EMS Personnel Should Be Asked/Required To Go Through A Defensive Tactics or Basic Martial Arts Course As A Requirement For EMS Training?

If I remember correctly, the IN glucagon is the same stuff as the IM. You just put the dose in the syringe and put on the aerator instead of a needle. In my experience I used glucagon IN a few times. I found it worked just the same as with IM. So, if you can't get the IV, go for the IN if you have it. and yes, google is your friend, but this is a discussion board where you, well discuss things. Having info on a med and how you use it is one thing, but actually talking about it with other providers is something google can't do.... yet.

Right is always right is too simplistic. What is right for the person may not be right for the company, what is right for the company may not be right for an employee. What is right for my family may not be right for your family. Does it make it WRONG? No. Does it make it less right? Depends on the person or outcome. While I may have a full time job, I may still need the extra job to support my family. While I understand your needs, for me my family and their needs have to come first. It would have been honorable for people to step down, but it's not about what others can do to make your life easier, it's about what they can do to support themselves. If I didn't need an "extra" job, I wouldn't have one. For your right is right senario: Lets say I give up my "extra" job which means I make less money. Now I have to chose between electric, rent or food. Sure you have your job, but because I had to work 2 jobs to make ends meet, I've lost my place to live. Would it still have been right for me to give up my hours? Yeah it sucks, and I'd be a little pissed if I were in your shoes too, but sometimes circumstances aren't what they seem. -MetalMedic

Whether or not our reports are taken seriously varies wildly- even in the same ER. Some docs really want a verbal report- especially on a critical patient. They want to know what we did and don't have time to read the written report. If I feel a nurse has not taken my verbal report seriously and there is an issue I want to stress, I try to wait until the doc goes in to see the patient(generally on the sicker ones, since the stable patients can wait a long time before the doc goes in.) Example- Recently we had a guy who as mid 60's, PMH of ETOH abuse, and seizures. His roommate said he heard the guy making funny noises, found him awake, no shaking, but nonverbal. He called it a seizure. The guy was completely lucid when we arrive, but could barely lift his head off the couch. He denied ETOH- we saw no evidence of it, and he said he was compliant with his meds. Mildly hypertensive, but I honestly cannot recall his vitals although everything else was essentially WNL. The patient was a poor historian, and getting information from him was like pulling teeth- he did not want to be bothered and denied having a seizure. After an exam, we realized this guy had left sided weakness. Further information was he had a history of a car accident 40 years ago, which resulted in a loss of a kidney, spleen, and he had extensive damage to his left leg, which left him with decreased function in that leg. He could not explain the arm weakness- it was new onset- approximately 2 hrs ago. As I was interviewing him further, the man began to fix his gaze to the left, which eventually progressed to a grand mal seizure. I gave Valium and within a minute or so, he was verbal again, but post ictal. Thankfully the receiving hospital was also a stroke center. I had already given the radio report before his grand mal seizure, so when we arrived at the ER(not the telemetry hospital we called), I notified the nurse of the changes. There was simply no time to recontact medical control AND treat the patient. She seemed fixated on the alleged seizure we were initially called for, ignored the weakness, and all but ignored the rest of the report. I completed the patient report and went back to the room to drop it off when I noticed the doc in the room. I interrupted him- politely- and quickly explained the whole history- his PMH, and he said something to the effect of "Well, that certainly changes things- I was told this was a simple seizure." He was worked up for a CVA, we were still within the allowable window for a fresh CVA, but I honestly have no idea what the outcome was. It was clear that the doctor was incredulous that so much pertinent information was left out of the report the nurse gave him. He took my run sheet and .proceeded to read it very carefully. He was quite appreciative that I took the time to directly brief him, and since then, if he is working, he always asks a couple pertinent questions as we roll by- even before he officially sees the patient. The thing about suicidal patients is that means they need a security stand by in an ER, a psych consult, and sadly I have seen nurses essentially ignore claims of suicidal thoughts. When questioned about it, the nurse says that the patient didn't really mean it, they are playing the system and the patient knows it generally means they get an overnight stay until they determine the patient is not a threat to themselves. Dangerous assumption to make, IMHO. Point is, you simply cannot assume the proper story is being relayed to the people who need to know. If in doubt, talk to the doctor directly since it's their ER, they are responsible for every patient, and it's their license on the line if something goes south.

You need to go to the Director of Nursing at that facility and explain what has happened. At the end of the day you have to realize that there is only so much you can do. Another avenue would be to call the "mental health crisis line" in your area (or whoever is the gatekeeper to such services) and explain the situation. Lastly, a visit to the hospital Risk Management Department or even the CEO may assist, sometimes leaders have a better view of liablity situations than the folks on the front line, and as impossible as it may seem, he may have been seen by different doctors who were not aware of the previous issues (even though you told a nurse). Also, I would make a note in your communications center about this patients recent activity so that he is transported every time. This is a lawsuit that is going to happen, would hate to see your company brought into it to, because someone got a refusal on him after 5 suicide attempts in 10 days).

OMG I think i just pissed my BDUs. Dwayne you ass hat Welcome to the City Bieber's SO. Congrats on the nuptuals! You have a good man there. As others have said he is a great medic. I would be proud to have him on my rig. For such a new medic he shows great knowledge, maturity, and devotion to the profession. We are proud to have him part of our little world. As far as the City goes. As you can see we have a wierd sense of humor so just roll with it. We speak our minds and usually hold nothing back. Ask an ye shall receive. We are willing to answer to the best of our knowledge if so asked. Feel free to join all the discussions and be part of our world. Again welcome!

First of all, kind of a silly quote... I dont think there is anyone who ALWAYS does the RIGHT thing. Besides, whats right varies with perception. The biggest problem here is the decision of the employer to implore people to "do the right thing." My definition of an adult manager would be someone who makes tough, but fair decisions. Not someone who sows discord among his staff by leaving them in control of shift scheduling.

I think I read, years ago in the reader's digest, a short story of a guy on a train, sharing the compartment with an old Asian man, when a man who presents as drunk and looking for a fight with anyone, enters the compartment. The first person tells of reviewing some of his Martial arts skills, to be used to defend himself and the elderly man, when the elderly man engages, in a calm manner, the agitated man, in conversation, and manages to calm the agitated man down, to the point that the guy actually ended up in a pleasant conversation. Afterwards, when the formerly agitated man leaves, the elderly one tells the story teller to the effect of, I saw you preparing to fight, but felt mine was the better way. Think about it.

If Chuck Norris were a paramedic, no one would ever get sick in fear of making him work and kicking their ass. When I went through medic school, we had a non-mandatory one night "self defense" class. It was nothing more than how to get yourself away if shit went sour. Yes, scene safety is key and we should never enter a bad situation. But sometimes they present themselves out of no where. It never happened to me, but it could. Would I stay and fight? No, I would get away any way I could. But making martial arts training mandatory is silly. Focus on how to make the patient better NOT worse.

Well, I'm not sure if we can help you understand what he does... I know that he's a closet meth addict, and a sexual deviant...something about ponies and electric shavers...other than that....Hmmm...it's gets cloudy.... I have seen you on his facebook page and warned him already that you're way to beautiful to be dating a medic..and once you get your RN will be completely out of his class...so please don't get married before graduation... Welcome to the City Babe. Justin, though only being a member for a short time is already well respected and well loved..he's like the little City hamster with the Beiber haircut that we never had....You will be proud of him....until you graduate...then you'll think he's an idiot...Just sayin'... :-) Dwayne

LMFAO..... That is pure comedy right there!! In all seriousness though.... you're claims are just words, without pics.

The true secret of the test? Read carefully, decide what you THINK they're asking YOU and then discard that and give the answer that you believe your retarded great dane would give...you'll be golden. Dammit, Dwayne! Spit my Diet Pepsi all over my lap top. You better hope my keyboard doesn't get gummed up or you are getting a bill...

It think that it's cool as hell that you took the time to do this...Truly in the Spirit of the City. When do you take the test? The true secret of the test? Read carefully, decide what you THINK they're asking YOU and then discard that and give the answer that you believe your retarded great dane would give...you'll be golden. Truly, people get all jammed up on the CBT because they really want to believe that they are trying to cull some of the less intelligent people..but they're not. They're making money. They want to know who can remember the simplest answers from their textbooks. If you find that you're thinking, "Ah Ha! Thought you tricked me didn't you, you shithead!!" You're screwed...it's not that kind of test... Thanks again for taking the time to post the study site... Dwayne

Obviously English is not your first language. Haitian is a national origin, not a race. Your racist assumptions have no place in this forum, so STFU.

I am liberal ? I thought I was quite the conservative, silly me. I would think it would be hippy liberals who all about having sex with minors, and excusing the behavior. Most liberals are closet child molesters, most conservatives are closet homos, glad I am independant.

Again, ass clown, you were terminated for this wonderous action that you saved the day with..OBVIOUSLY you were right all along!! I am pretty sure it happend for good reason, yea- your former boss had a brain!! Kudos to your former boss buddy, tell him I said thanks, he did that town a favor. Do yourself a favor, put the gun away and get the books back out jackass..

un·con·scious (n-knshs) adj. 1. Lacking awareness and the capacity for sensory perception; not conscious. 2. Temporarily lacking consciousness. 3. Occurring in the absence of conscious awareness or thought: unconscious resentment; unconscious fears. 4. Without conscious control; involuntary or unintended: an unconscious Here ya go Ruff, In case you were not aware, Lidocaine is not indicated for unconscious persons. I have provided you with the definition of unconsciousness. I agree with you, Lidocaine IS, infact given to reduce pain. When your unconscious, guess what.... you feel no pain. Lidocaine.....Here is what you just gave an unconscious pt..... Adverse Reactions Systemic Adverse experiences following the administration of Lidocaine HCl are similar in nature to those observed with other amide local anesthetic agents. These adverse experiences are, in general, dose-related and may result from high plasma levels caused by excessive dosage, rapid absorption or inadvertent intravascular injection, or may result from a hypersensitivity, idiosyncrasy or diminished tolerance on the part of the patient. Serious adverse experiences are generally systemic in nature. The following types are those most commonly reported: Central Nervous System CNS manifestations are excitatory and/or depressant and may be characterized by lightheadedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, vomiting, sensations of heat, cold or numbness, twitching, tremors, convulsions, unconsciousness, respiratory depression and arrest. The excitatory manifestations may be very brief or may not occur at all, in which case the first manifestation of toxicity may be drowsiness merging into unconsciousness and respiratory arrest. Drowsiness following the administration of Lidocaine HCl is usually an early sign of a high blood level of the drug and may occur as a consequence of rapid absorption. Cardiovascular System Cardiovascular manifestations are usually depressant and are characterized by bradycardia, hypotension, and cardiovascular collapse, which may lead to cardiac arrest. Allergic Allergic reactions are characterized by cutaneous lesions, urticaria, edema or anaphylactoid reactions. Allergic reactions may occur as a result of sensitivity either to local anesthetic agents or to the methylparaben used as a preservative in the multiple dose vials. Allergic reactions as a result of sensitivity to Lidocaine HCl are extremely rare and, if they occur, should be managed by conventional means. The detection of sensitivity by skin testing is of doubtful value. Neurologic The incidences of adverse reactions associated with the use of local anesthetics may be related to the total dose of local anesthetic administered and are also dependent upon the particular drug used, the route of administration and the physical status of the patient. In a prospective review of 10,440 patients who received Lidocaine HCl for spinal anesthesia, the incidences of adverse reactions were reported to be about 3% each for positional headaches, hypotension and backache; 2% for shivering; and less than 1% each for peripheral nerve symptoms, nausea, respiratory inadequacy and double vision. Many of these observations may be related to local anesthetic techniques, with or without a contribution from the local anesthetic. DO NO HARM, Fluids are indicated in stroke pts, IF THEY ARE HYPOTENSIVE !!!! Do I have to explain why Ruff?? Probably, but I'm not. You can do your research. I am not waisting my time on this any longer. I have done plenty of IOs , WHEN THEY ARE WARRANTED!!!! You two deserve each other!!!

Yep D- it was from Medscape. A great website, you should read it more. You might learn something.... As a matter of fact reading articles like that one prior to your screw up might have changed things for the better for your pt, that you put an unnessesary hole in their leg and administered a potential toxic medication to... Maybe you should frequent this site less, and go job hunting . JB

Justin beiber, let me shed some light for ya....the IO should not even have been placed, unless the the useful hormone that we have in a siringe did not work!! Brain child you are buddy!!! Please do, go back to driving the ambulance, and better yet make it a transport company so you are not presented with critical patients Justin Beiber....

Would you have been happier if I stated that the comment by the poster came off as ethnocentric, or derogatory towards Haitians? Either way, the point was made, and I would respect yours much more if you had not felt the need to take to insulting me in your post. Also, STFU, really? I thought this was a professional forum...